Walk through leaves

Walking through town today.
Fallen leaves, assorted browns and faded oranges,
Lie scattered along path.
Air is crisp.
Football game at the college.
Some sort of sporting event at the high school.
Dull roar of crowds from both fields.

Streets crowded
With families and young people:
Elementary school girls playing tag on the church lawn;
Adolescent boys, effortlessly slender, strolling languidly in their hormonal pack;
Entitled fraternity bros
In designer skinny jeans
Smoking vapes and laughing
With perfect dentition.

I go unnoticed.
Heaviness descends,
Slows my gait to a shuffle as I walk through leaves.
How badly I long
For a friend,
A lover,
A smile.



Our family cat Russell died this week.  He was eighteen years old.

My brother and I adopted Rus from a city animal shelter in the aftermath of the May 3rd 1999 tornado in Oklahoma City.  At the time, we were 9 and 12 years old, respectively.  Russ was three weeks old.  Over the ensuing two decades, we three boys grew up together.

When we adopted him, Rus weighed less than a pound and didn’t know how to drink water from a bowl.  My brother and I took turns dipping our fingers in water and letting Rus lick the drops.  For the remainder of his life, he “drank” by putting his paws in the water bowl and then licking them dry.  We build giant Lego houses for him in our bedroom.  We dressed him up as the Pope for one Halloween.  He was the reliable constant during our turbulent adolescent years.  He was fearless, intelligent, and fiercely loyal to his two boys.  He once chased a neighborhood kid into a bathroom because the kid had pantomimed punching my brother.  He slept in our beds at night, keeping some sort of internal schedule by which he rotated between my brother and me.  His favorite toys were rabbit foot tchotchkes.  We trained him to walk on a leash, and he loved going for long explorations outside.  He was the third son of our family.  We nicknamed him “Tubbs.”

By the time I was in medical school, Rus had developed diabetes.  Because he was otherwise healthy, we chose to treat him with insulin, and he thrived for another four wonderful years.  This week, the inexorable hand of age caught up with him, and he passed peacefully of kidney failure.  He fell asleep for the last time on his favorite blanket: a red Christmas tree skirt with white fringe.

It is hard to believe that you’re not here anymore, Russell; you were a constant for so many years.  I know you loved us as much as we loved you.  Thank you for everything.

I’ll miss you, Tubbs.

Elegy for Stephanie

Late at night, silence and snowflakes fill corners of windowpanes.  Phone call.
On your sled, hit by a truck.  Time and breath slow to a crawl.
Hearing but not understanding, I sit on the couch in the darkness.
Fuck god or infinite space, this is supposed to be justice?
There are no tears
for pain beyond a certain deep.
This I discover
on the day you sleep.

Brilliant, industrious, brave, and compassionate, you were my best friend.
Greater than I were you, though: seeking our world to mend.
Founder of medical clinics, staunch steward of Earth, leader.  You cared,
Never gave up on your dreams, accomplishing more than most dare.
A passing light,
what did you leave
but kindness, health,
and joie de vivre?

Springtime has come, but within my heart, snow remains. How do I move on?
Formerly, I would ask you.  Where do I turn with you gone?
Distance and wisdom will show me one day that the truth is plain: you stayed
Endless, immortal, and here, alive in the lives you have changed.
So, half as good as thou
I’ll try to be,
For I love you,


The last time I saw Martha was on a blustery November afternoon, when her eighty-year-old emaciated body lay bedridden, wheezing, and curled in the fetal position, a tiny sickly lump of human flesh with wiry unwashed grey hair, eyes squeezed tightly shut, and a wrinkled face contorted in pain or despair or both.  A few days later, she died, and a then second-year medical student was forced to cope with the first real loss in his life.

Martha and I had first met four years earlier when, during a religious period in my life, I responded to a church bulletin asking for volunteers to visit this elderly, widowed German lady who was confined to nursing care and who could not attend worship services.  Nearly every Saturday afternoon thereafter, she and I would meet for an hour of snacks and pleasant conversation, and I grew to know her well.  In the late 1940s, after having lost her entire family to Nazi persecution, she had immigrated to the U.S. as the new bride of a dashing young Air Force captain.  Their marriage was long and happy, and after her husband died, she remained fiercely patriotic, decorating her nursing home bedroom with American flags, pictures of the Statue of Liberty, and “God Bless the USA” plaques.  Her two adult children, unfortunately, had little to do with her aside from managing her finances; and so, my weekly visits served as the key highlights of Martha’s last years of life.

On that chilly autumn day when I sat by her bedside for what would become the final occasion, thin nasal cannulae snaked out from her nostrils and across the grimy, long-unwashed sheets to a bedside oxygen machine whose noisy gurgling disturbed the room’s otherwise funereal silence.  Martha lived in a cheap, disreputable nursing facility; her small, poorly lit, dank apartment reminded me of a dungeon.  She had wrapped herself into her favorite blanket, a tattered fleece quilt with a pattern of little red cardinals hopping along tree branches against a background of forest green leaves.  Her bed had a stout wooden frame surmounted by an even stouter headboard that had built-in shelves and drawers decorated with innumerable USA-themed memorabilia, tiny plastic biblical figurines, and stacks of old greeting cards.  The giant structure engulfed Martha’s frail, dying body, and the mattress reeked of stale urine.  “Martha…it’s me. Martha, can you hear me?” I whispered loudly, cognizant of her poor hearing.  She responded to my greeting by turning a bleary-eyed ashen face to me, muttering something incoherent, and falling immediately back into a stupor.  She died four days later, before my next weekly visit.

For some time after Martha’s death, I felt haunted by our last moment together and how it hadn’t ended in cinematic fashion, with the dying character imparting a brilliant, life-altering message to the captivated audience.  According to popular lore, Martha should have awakened, turned lucid eyes to me one last time, and whispered some deep philosophical advice as her parting words.  Instead, she gave me a vacant, expressionless stare and an unintelligible mumble.  I felt as though she and I had in some way failed because we did not generate the necessary amount of profundity and significance during that final encounter.  This sense of failure threatened to eclipse the many fond memories I held from our preceding four years of friendship.  I kept wondering, was all of our time together meaningless simply because the last moments before death seemed so unsatisfactorily unremarkable?

The answer, I have eventually realized, is no.  Do not overemphasize the importance of “last words.”  Obsessing over a loved one’s departing words simply adds undue stress to an already tense moment.  The surviving kith and kin hover ’round their dying friend or family member and scour their final breaths for meaning, coming away disappointed and distraught if they uncover no timeless, breathtaking, everlasting truths.  Fixation on the perimortem period can cause us to overlook the day-to-day words and experiences of life, believing them to hold less importance than the words spoken on the deathbed.  This thinking is fallacy.  The opportunities for gaining wisdom, the chances for finding meaning and wonder and remembrance, come to us daily in our interactions with others.  Life is simply too rich a soil to bear fruit only on the eve of the harvest; instead, we should search daily for new growth.

I kept waiting for Martha to awaken and impart to me some penetrating, soul-shaking, sagacious insight that would shape evermore the direction of my destiny.  She didn’t.  She had already spoken those words, in the countless afternoons we spent talking with one another; in the shaky, scribbled lines of the letters she constantly mailed to me; and in the laughter we shared over hamburger and onion pizza–her favorite.  Her memory should not be relegated to a single, cold, November day out of the hundreds of beautiful, sun-filled, happy ones we enjoyed.  Her brilliance, her beauty, and her wisdom, they were found in her life, not in her death.

Major Depressive Disorder

Everyone feels sad at times.  It’s not a disease.
Shit happens.
Get over it.
Have a beer.
Be a man.
Grow a pair.
You don’t need Prozac,
You need a backbone.
Get off your duff
And get to work.

A healthy and intelligent son
In a supportive, middle-class, two-parent, two-sibling, Protestant household
In rural Oklahoma,
I knew
Depression is a made-up condition
For liberal West Coast hippies
Who’ve strayed from God’s path
And who have never earned an honest day’s living.

Then I went away to college,
To grad school,
To med school,
And tried to kill myself
By jumping
In front of a city bus.

It’s a serotonin imbalance in the brain.
I can trace the neural pathways for you;
I got an A in neuroscience.
But black textbook arrows through the amygdala don’t tell it:
The stasis that permeates one’s being,
Until your muscles feel sodden
And your thoughts struggle against a palpable, impenetrable grey.

Rise from bed every morning, O Sisyphus.
The entropic dissolution of vitality.

Even with selective serotonin reuptake inhibitors,
You turn to other remedies:
Coffee, cocaine, mutilation, masturbation,
Writing, reading, running, swimming,
Highway driving at 3 AM, 110 mph, windows down, radio up, headlights off.

To dispel,
For a fleeting instant,
The lassitude, stillness, and weight
Of this disease
That we all know
Is merely an excuse
For laziness.